医院获得性鲍曼不动杆菌感染和不断变化的抗生素耐药性。
Nosocomial Acinetobacter baumannii Infections and Changing Antibiotic Resistance.
机构信息
Ismail Necati Hakyemez, Specialist of Infectious Diseases and Clinical Microbiology, Sevket Yilmaz Training and Research Hospital, Bursa, Turkey.
Abdulkadir Kucukbayrak, Assistant Professor of Infectious Diseases and Clinical Microbiology, Abant Izzet Baysal University Medical Faculty, Bolu, Turkey.
出版信息
Pak J Med Sci. 2013 Sep;29(5):1245-8. doi: 10.12669/pjms.295.3885.
OBJECTIVES
In the intensive care setting, Acinetobacter baumannii causes ventilator-associated pneumonia and other nosocomial infections that are difficult to treat. Objective of this study was to investigate nosocomial A. baumannii infections and its changing antibiotic resistance.
METHODS
A total of 56 patients diagnosed with A.baumannii infections between January 2009 and December 2011 were included in the study. Diagnosis for nosocomial infections was established according to the CDC (Centers for Disease Control and Prevention) criteria. Identification of the agents isolated was carried out using conventional methods and VITEK 2 automated system, while antibiotic sensitivity testing was performed through VITEK 2 AST-N090 automated system.
RESULTS
The most common infection was nosocomial pneumonia by 43%, among which 46% were ventilator-associated pneumonia. Considering all years, the most effective antibiotics on the isolated strains were found as colistin, tigecycline, imipenem and meropenem. However resistance to imipenem and meropenem was observed to increase over years.
CONCLUSION
The issue of increased resistance to antibiotics poses difficulty in treatment of A. baumannii infections which in turn increases the rate of mortality and cost. In order to prevent development of resistance, antibiotics must be used in an appropriate way in accompanied with proper guidance.
目的
在重症监护病房，鲍曼不动杆菌可引起呼吸机相关性肺炎和其他医院感染，这些感染难以治疗。本研究的目的是调查医院获得性鲍曼不动杆菌感染及其抗生素耐药性的变化。
方法
本研究共纳入 2009 年 1 月至 2011 年 12 月期间诊断为鲍曼不动杆菌感染的 56 例患者。医院感染的诊断根据美国疾病控制与预防中心（CDC）的标准确定。采用常规方法和 VITEK 2 自动化系统进行分离物的鉴定，采用 VITEK 2 AST-N090 自动化系统进行抗生素敏感性检测。
结果
最常见的感染是医院获得性肺炎，占 43%，其中 46%为呼吸机相关性肺炎。考虑所有年份，分离株最有效的抗生素为黏菌素、替加环素、亚胺培南和美罗培南。然而，亚胺培南和美罗培南的耐药性呈逐年上升趋势。
结论
抗生素耐药性增加的问题给鲍曼不动杆菌感染的治疗带来了困难，从而增加了死亡率和成本。为了防止耐药性的发展，抗生素的使用必须与适当的指导相结合，以适当的方式使用。
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